De Fina S, Franciosi C, Codecasa G, Real G, Colombo G, Visintini G, Romano F, Uggeri F
Divisione di Clinica Chirurgica I, Università degli Studi, Milano.
Minerva Chir. 2000 Mar;55(3):133-7.
Clinical results of colic anastomosis using biofragmentable anastomosis ring (BAR-Valtrac) are presented. Such a method showed to be a real alternative technique to the usual ones.
Eighty-six colic anastomosis using BAR are collected, 76 of which performed as elective surgery and 10 in emergency. The patients were 47 males and 39 females, with a mean age of 64 years. In 63 cases the patients were affected by colic neoplastic disease, in 16 by complicated diverticular disease (stenosis or perforation) and 7 patients had neoplastic disease of other organs involving the colon BAR device was used in 48 colic reconstructions after segmentary resection and in 38 colic reconstructions after left hemicolectomy. In each case 31-34 mm BAR were used.
No perioperative death occurred in our series. Only one case (2%) of anastomotic leak was observed, while in 3 cases (4%) intestinal canalization disorders occurred. No problems for ring expulsion occurred in any patient. Three late complications were observed, as three cases of asymptomatic substenosis discovered during instrumental follow-up and spontaneously cleared up.
On the basis of clinical results, and according to those reported in literature BAR anastomosis is considered a safe, feasible and easy technique to perform colic anastomosis, even in emergency, limited to the intraperitoneal tract of the colon.
介绍了使用可生物降解吻合环(BAR-Valtrac)进行结肠吻合术的临床结果。这种方法被证明是一种替代传统方法的实用技术。
收集了86例使用BAR进行的结肠吻合术病例,其中76例为择期手术,10例为急诊手术。患者中男性47例,女性39例,平均年龄64岁。63例患者患有结肠肿瘤性疾病,16例患有复杂性憩室病(狭窄或穿孔),7例患者患有累及结肠的其他器官肿瘤性疾病。48例节段性切除术后结肠重建和38例左半结肠切除术后结肠重建使用了BAR装置。每例均使用31 - 34毫米的BAR。
我们的系列病例中无围手术期死亡发生。仅观察到1例(2%)吻合口漏,3例(4%)出现肠道通畅障碍。所有患者均未出现吻合环排出问题。观察到3例晚期并发症,为器械随访期间发现的3例无症状性轻度狭窄,均自行缓解。
基于临床结果,并根据文献报道,BAR吻合术被认为是一种安全、可行且易于实施结肠吻合术的技术,即使在急诊情况下,也仅限于结肠的腹腔内段。